Earticle

본 연구는 간호대학의 교육과정에서 시뮬레이션을 활용한 실습교육과정의 적용가능성을 평가하기 위함이다. D시 소재 일 간호대학에서 시뮬레이션을 활용한 실습교육을 임상실습과 병행하여 받은 일 개 학년 학생들을 대상 (n=77)으로 2년 동안의 임상수행능력, 임상수행자신감, 비판적 사고성향 및 문제해결능력의 변화를 파악하기 위해 시행 된 종단연구이다. 본 연구대상 대학의 실습교육과정 평가를 위해 수집된 자료 중 일부(2015∼2016년도)를 사용한 2차 자료분석으로, 3학년과 4학년의 학년 초와 학년 말에 측정된 변수들을 반복측정분산분석으로 분석하였다. 연구결과, 4학년에서의 임상수행능력이 학년 초에 비해 학년 말에 유의하게 향상되었고(t=-13.75, p <.001), 임상수행자신감과 비 판적 사고는 2년에 거쳐 유의하게 증가되었다(F=177.86, p <.001; F=247.79, p <.001). 한편, 문제해결능력은 시점에 따른 유의한 차이가 없었다.

This study was to examine the effects of simulation used additionally in clinical practicum and evaluate its applicability in an undergraduate nursing curriculum. A longitudinal survey was used to measure the changes on the scores of clinical competency, clinical confidence, critical thinking and problem solving ability of students(N=77) who had experienced simulation in the clinical practicum curricula throughout their junior and senior years. Variables were measured 4 times, at the beginning and the end of each year, and data were analyzed using repeated measures of ANOVAs. Clinical competency score in senior year improved significantly(t=-13.75, p <.001) whereas no significant changes in junior year. Clinical confidence and critical thinking disposition over 2 years showed significant increases(F=177.86, p <.001; F=247.79, p <.001, respectively). Problem solving ability increased throughout the junior and senior years, however, it did not make a significant difference at any point of measures.

Purpose: The purpose of the study was to investigate the continuous effect of advanced cardiovascular life support (ACLS) simulation education according to Felder-Silverman learning style. Methods: A self-reported questionnaire was completed by 94 students of emergency medical technology and nursing. There were 50 female students (53.2%) and 88 students (93.6%) had basic life support certification. The study instruments included knowledge, performance, and confidence. Data were analyzed using SPSS v. 20.0. Results: The learning style consisted of reflective type (51.1%), sensory type (76.6%), visual type (63.8%), and sequential type (64.9%). There was a significant difference in continuous effect on performance by learning type. Conclusion: It is necessary to identify the learning style of students before simulation education in order to maintain continuous effect of ACLS education.

The purpose of this study was to explore and describe the problem solving process of nursing students in a simulated clinical situation. Using grounded theory method, data were collected and analyzed from March to September, 2013. The participants were undergraduate students who had two times of experiences to participate in high-fidelity clinical simulation. Four major categories emerged from the data explained the phases of process which nursing students followed to solve their problems in the simulated clinical situation: ‘getting missions’, ‘feeling oppressed from the clinical situation designed for evaluation’, ‘performing missions and mobilizing strategies for being well received’, ‘self-reflections and professional growth’. The core category was ‘completing missions in order to be evaluated as a competent nursing student in the arraigned clinical situation.’

Purpose: The purpose of the study is to confirm the effect of ACLS program using simulations and understanding self-efficacy, practice satisfaction, learning attitude, and interest in ACLS after theory classes and simulation-based practice. Methods: A non-equivalent simulation-based practice post test design was used. The participants were 28 paramedic students. The students participated in simulation- based practice for 3 weeks and conventional instruction class for 12 weeks. Results: The students showed higher level of self-efficacy(p =.043), practice satisfaction(p <.001) and learning attitude(p =.003) compared to the conventional lecture students. Conclusion: Level of self-efficacy after simulation-based practice for ACLS was higher than that of self-efficacy after conventional instruction classes. Level of practice satisfaction was also higher. Academic achievement after simulation-based practice was higher than that in conventional instruction classes.

Purpose: Standardized patient-based simulation is known to be a useful tool in the training of nursing students;however, few studies have examined the use of this method in oncology nursing education. This study aimed toevaluate the effects of an oncology nursing simulation program that used standardized patients on knowledge,nursing performance ability, and satisfaction among nursing students. Methods: This study used a non-equivalentcontrol group pretest-posttest design. The experimental group (n=25) participated in an 8-hour oncology nursingsimulation program that consisted of a lecture (2 hours) and a four-session simulation program(6 hours). The controlgroup (n=29) received case-based learning (6 hours) and a lecture (2 hours). Knowledge level was assessed witha 33-item knowledge assessment multiple-choice questionnaire. Nursing performance ability was assessed witha nursing performance ability checklist. Educational satisfaction was evaluated using the 12-item Course SatisfactionEvaluation tool. Data were collected from June to July of 2012 and were analyzed using descriptive statistics,independent t-test, and repeated measures analysis of variance. Results: The experimental group showed significantlyhigher nursing performance ability and satisfaction compared with the control group. Knowledge of oncologynursing increased in both the experimental and control groups. Conclusion: An oncology nursing simulation programwas more effective than case-based learning in improving nursing student performance and was found to producehigh satisfaction.

Purpose: Since the COVID-19 pandemic, virtual simulation practice has been increasingly activated as an alternative to clinical practice in nursing colleges. This study aimed to provide basic data by confirming changes in self-efficacy and nursing knowledge in the virtual simulations of nursing students, and identifying virtual presence, virtual patient learning system evaluation (VPLSE), and practical satisfaction. Methods: This was a single-group pre-post quasi-experimental study. The subjects were 28 third-grade nursing students. Results: Self-efficacy and nursing knowledge increased significantly (p<.001). Virtual presence had a significant positive correlation with VPLSE) (p=.002) and practice satisfaction (p=.011). There was also a significant positive correlation between virtual simulation learning evaluation and practice satisfaction (p<.001). Conclusion: Based on these results, virtual simulation practice can be used with clinical practice as an educational method to improve nursing students' self-efficacy and nursing knowledge in nursing education. Virtual presence was confirmed as a significant variable to improve practice satisfaction and VPLSE. It is necessary to develop a virtual simulation program that can improve virtual presence through collaboration with virtual reality technology experts.

Purpose: This study aimed to develop and implement a multi-patient simulation (MPS) program for nursing students with no prior clinical practice experience. It also examined the effects of the program on the students’ communication competence and clinical reasoning ability. Methods: A one-group pretest-posttest design was used. The MPS program, consisting of four patient scenarios was applied to second-year nursing students with no prior clinical practice experience. Communication competence, clinical reasoning ability, and the perceived effectiveness of the multi-patient simulation program were measured using structured tools before and after the program. Results: Communication competence significantly improved after the MPS program, whereas clinical reasoning did not show a statistically significant difference. Perceived effectiveness of the MPS program was generally high, with the debriefing component scoring the highest. Confidence scores were relatively low, suggesting the need for level-appropriate scenario. Conclusion: The MPS program was effectively enhanced communication competence among preclinical nursing students. Although clinical reasoning scores did not improve significantly, the study highlights the importance of introducing realistic simulation experiences early in nursing education. Future research should focus on developing suitable clinical reasoning assessment tools for early year students and conducting randomized controlled trials to validate the effectiveness of customized MPS programs.

Purpose: This study was conducted to confirm the effects of patient safety simulation education on nursing students’s attitude of patient safety, confidence in performance of patient safety, confidence in performance multidrug-resistant bacterial infection control, and nursing professionalism. Methods: In this study, 89 students from the 4th grade of the nursing department at one university participated, and the data collection period was from August 20 to August 30, 2023. The collected data were analyzed using R 4.3.2 version and by descriptive statistics, independent t-test, Pearson’s correlation coefficients. Results: After education, the subjects' nursing professionalism(t=-5.95, p<.001), attitude of patient safety(t=-3.59, p<.001), confidence in performance of patient safety(t=-3.90, p<.001), and confidence in performance multidrugresistant bacterial infection control(t=-5.55, p<.001) increased statistically significantly. After education, there was a positive correlation between nursing professionalism, attitude of patient safety(r=.43, p<.001), confidence in performance of patient safety(r=.64, p<.001), confidence in performance multidrug-resistant bacterial infection control(r=.41, p=<.001). The relationship between attitude of patient safety, confidence in performance of patient safety(r=.47, p<.001), confidence in performance multidrug-resistant bacterial infection control(r=.37, p=<.001) showeda positive correlation. Confidence in performance of patient safety, confidence in performance multidrug-resistant bacterial infection control(r=.80, p<.001) showed a positive correlation. Conclusion: Through this study, in order to strengthen effective patient safety management behavior, it is necessary to find ways to increase immersion and proactiveness in education by developing and applying various scenarios related to patient safety in nursing management simulation education.

Purpose: The purpose of this study was to investigate the effects of simulation training using virtual reality on patient safety confidence and safety care performance of nursing students. Methods: This study used a one group pretest-posttest design. Among the nursing students enrolled in a nursing practice in one nursing school, the convenience sample of 104 students was recruited. Participants accomplished the simulation training using virtual reality on patient safety for 2 hours once a week for three weeks and completed a self-filled questionnaire. Data were analyzed using a descriptive statistics, paired t-test, and Pearson correlation coefficients. Results: After the simulation training using virtual reality on patient safety, there were a significant difference in patient safety confidence and safety care performance of nursing students. Conclusion: Based on the results of this study, the simulation training using virtual reality on patient safety can be used as an effective learning strategy to improve patient safety nursing performance of nursing students and provided basic data for developing a systematic curriculum necessary for patient safety nursing performance.

Purpose: This study examined the effects of a morphine overdose patient care simulation education program on nursing students’ error reporting intention, disclosure self-efficacy, patient safety attitude, and ethical decision-making confidence. Method: A quasi-experimental one-group pretest?posttest?follow-up design was used with 44 senior nursing students enrolled in a nursing management simulation course. Participants completed a simulation program incorporating error reporting, disclosure, and ethical decision-making. Data were collected at pretest, posttest, and a 4-week follow-up and analyzed using linear mixed models. Results: All outcome variables significantly improved over time. Compared with pretest scores, error reporting intention significantly increased at posttest and follow-up (β=.415, p=.001; β=.401, p<.001). Disclosure self-efficacy also increased at posttest and follow-up (β=.523, p=.002; β=.541, p=.001), as did patient safety attitude (β=.260, p<.001; β=.292, p=.003) and ethical decision-making confidence (β=.381, p=.002; β=.505, p<.001). No significant differences were found between posttest and follow-up. Conclusion: The program was associated with improvements in nursing students’ error reporting intention, disclosure self-efficacy, patient safety attitude, and ethical decision-making confidence. These findings suggest that the program may help strengthen nursing students’ competencies in responding to patient safety incidents.

Purpose: This study aims to investigate the effect of a simulation-based patient safety performance improvement education program on caregivers’ knowledge, attitude, and performance toward safety. Methods: This study adopted a quasi-experimental design that applied before-and-after designs for the test and control groups. It was configured focusing on “infectious disease,” “fires,” “falls,” and “drug abuse.” Results: There was a significant difference in knowledge and patient safety performance between the experimental group and the control group. However, there was no significant difference in attitudes toward safety. Conclusion: The results of this study showed that the simulation-based patient safety performance improvement education program is effective in improving patient safety performance. Therefore, it is necessary to continuously apply and evaluate the simulation-based patient safety performance training program to enable caregivers to develop professional prevention and management capabilities within elderly care facilities.

Purpose: This study evaluated the impact of a nursing simulation learning module for caring for patients with chronic obstructive pulmonary disease (COPD) on nursing knowledge, clinical competence, team psychological safety, and learning satisfaction among nursing students. Methods: A non-equivalent control-group pretest?posttest quasi-experimental design was used with 36 students (18 per group) assigned to either a simulation group or a lecture group. Data collected from June 8 to July 13, 2024, were analyzed using SPSS 27.0. Results: Nursing knowledge showed no significant between-group difference (F=1.32, p=.260) but improved over time (F=8.24, p=.007). Clinical competence showed a significant group-by-time interaction (F=58.33, p<.001). Team psychological safety (t=2.70, p=.012) and learning satisfaction (t=2.27, p=.030) were higher in the simulation group. Conclusion: These findings provide foundational data for developing simulation-based educational strategies in nursing curricula. The module may also be applied to the training of novice nurses in clinical settings, thereby contributing to enhanced nursing education and improved clinical practice.

Purpose: This study aimed to evaluate the effects of simulation education in patient safety nursing on nursing students’ attitudes toward patient safety, confidence in patient safety, academic self-efficacy, and academic engagement. Methods: The study was conducted from April to May 2022 with 69 nursing students enrolled in a fundamental nursing practice course. Two simulation scenarios were developed to enhance the patient safety competencies. Each scenario was implemented in two sessions, each lasting 90 minutes. Data were collected using self-report questionnaires, which measured attitudes toward patient safety, confidence in patient safety, academic self-efficacy, and academic engagement before and after the simulation education. Data were analyzed by employing descriptive statistics and paired t-tests using SPSS Statistics Version 26.0. Results: After participating in the simulation program, students showed statistically significant improvements in their attitudes toward patient safety (t=9.11, p<.001), confidence in patient safety (t=15.66, p<.001), academic self-efficacy (t=6.03, p<.001), and academic engagement (t=9.28, p<.001). Conclusion: The findings suggest that simulation education in patient safety nursing is an effective nursing education strategy. The study highlights the need to develop and expand diverse simulation-based learning programs in nursing education.

본 연구는 시뮬레이션 기법을 이용하여 검진센터의 환자 흐름을 효과적으로 관리할 수 있는 방안을 마련하고자 수행되었다. 이를 위해 실제 병원의 검진자료를 활용하여 15개의 검진환자군을 분류하고, 최대 검사시간, 최소 검사시간, X-ray 추가도입에 근거한 3개의 시나리오를 개발하였으며, 시뮬레이션 프로그램은 Flexsim HC 2.7을 이용하였다. 분석결과 최대 검사 소요시간에 근거한 제 1시나리오에서 평균 검사 소요시간과 최대 검사 소요시간의 차이가 가장 크게 나타났으며, 시간대별 환자 수의 증가에 따른 평균 검사 소요시간이 가장 큰 폭으로 증가하였다. X-ray 장비 추가에 따른 평균 검사 소요시간의 차이는 미미한 것으로 나타나 도입의 필요성은 없는 것으로 분석되었다. 시뮬레이션 기법을 이용한 분석을 통하여 환자대기시간 관리, 장비의 효율적인 도입을 위한 의사결정 지원이 가능함을 확인할 수 있었으며, 구체화된 시나리오를 통해 가장 적정한 검사흐름과 시간대별 환자 수를 파악한다면 병원 경영의 효율화에 크게 이바지할 수 있을 것이다.

This study aims to develop the methods for effective patient flow in the medical center through simulation modeling. To achieve this, we developed three simulation scenarios based on max/min processing time and addition of X-ray by 15 patient tracks from real hospital data. The simulation software used in this study is Flexsim HC 2.7. According to the scenario 1 on 15 patient tracks' LOS by max processing time, there is a great difference between average length of stay(LOS) and max LOS. And average LOS increases greatly depending on the number of patients by the hours. There is no need to add extra X-ray because the addition of X-ray has not much influence in average LOS. It is possible to make good decisions on patient flow management and medical equipment purchasing through simulation modeling. The concrete simulation scenario as a tool for decision support will contribute to efficiency in hospital management.

Purpose: This study aimed to development and test the effects of patient safety/infection control simulation program based on a brain-based learning framework for nursing students. Methods: This pilot study used a one group pre-post test design. The study was conducted in one university in Korea. Participants were recruited using a convenience sample. Fifteen nursing students participated in this study. Results: The levels of perception of importance of patient safety management (Z=3.41, p=.001), confidence on patient safety (Z=3.30, p=.001), attitude toward personal protective equipment (Z=3.10, p=.002), and efficacy of personal protective equipment (Z=3.35, p=.001) were significantly increased. Conclusion: The application of brain-based learning framework in nursing simulation could be an effective education for nursing students.

Purpose: This study aimed to identify the need for simulation education to strengthen patient safety competencies in nursing practice field experience and explore and analyze improvements in simulation education. Methods: Data were collected through focus group interviews with 31 participants from four groups of fourth-year nursing students and one group of new nurses from August 7, 2023 to February 11, 2024. Interview data were systematically reviewed by qualitative content analysis. Results: Five major themes were identified; (1) awareness of patient safety competencies among nursing students and new nurses, (2) awareness of patient safety education among nursing students and new nurses, (3) simulation education topics for strengthening patient safety competencies, (4) interfering factors of simulation education for strengthening patient safety competencies, and (5) facilitating factors of simulation education to strengthen patient safety competencies. Accordingly, 15 categories were derived, and the current status of simulation education for patient safety, educational needs, and improvements were reported. Conclusion: This study attempted to reflect on the needs of learners before developing a simulation education program and derive educational content to strengthen patient safety competencies.

본 연구는 시뮬레이션 수업을 통한 간호대학생의 안전간호 활동 경험을 탐색하기 위해 시행되었다. 자료 수집은 2023년 6월에 시뮬레이션 수업에서 환자안전간호 시나리오를 경험한 간호대학생 15명을 대상으로, 포커스 그룹 인터뷰를 통해 이루어졌다. 분석은 질적내용분석 방법을 이용하였다. 연구결과 5개 주제와 16개의 하위주제 가 도출되었다. 간호대학생의 환자안전간호 경험의 5개 주제는 ‘환자안전을 위한 기본요소 관리’, ‘환자안전 관리의 영역 확대’, ‘환자안전에 필요한 역량 인식’, ‘역량 강화가 필요한 환자안전간호 활동’, ‘환자안전역량의 성장’으로 나타났다. 본 연구를 통해, 간호대학생의 환자안전간호에 대한 사고가 환자 중심으로 변화됨을 확인하였으며, 투약 간호에 대한 역량 강화는 지속적으로 이루어질 필요가 있음을 확인하였다. 또한, 시뮬레이션을 활용한 환자안전간 호 학습의 효과성이 확인되었으므로, 이를 활용한 환자안전 학습을 제안한다.

This study was conducted to explore the experiences of nursing students in patient safety nursing activities through simulation classes. Data were collected in June 2023 through focus group interviews with 15 nursing students who participated in patient safety nursing scenarios in simulation classes. The data were analyzed using a qualitative content analysis method, which revealed five main themes and sixteen sub-themes. The five main themes of nursing students' experiences with patient safety nursing were: 'management of basic elements for patient safety', 'expanding the scope of patient safety management', 'recognition of competencies required for patient safety', 'nursing activities requiring competency enhancement' and inner growth toward expertise in patient safety'. This study confirmed a shift in thinking toward patient-centered safety among nursing students and highlighted the need for ongoing competency enhancement in medication safety nursing. Additionally the effectiveness of patient safety nursing education using simulation was verified, suggesting the active use of simulation for patient safety learning.

Purpose: Effective communication is essential for the nursing profession. This study aimed to develop and investigate the impact of SBAR simulation training on nursing students' SBAR ability, hand-off confidence and communication confidence. Method: This study used a non-randomized, pre-post group design. Sixty nursing students were assigned to an experimental group and a control group. The simulation for SBAR training consisted of a 120-minute lecture, simulation, and debriefing for child with enteritis in neonatal intensive care unit. Data were collected from October, 2023 to April, 2024 and analyzed by the descriptive statistics, Chi square test, independent t-test, and paired t-test using the SPSS/WIN 24.0 program. Results: Upon completion of applying SBAR simulation training, the experimental group showed significantly higher SBAR ability (t=5.39, p<.001), hand-off confidence (t=2.58, p=.002) and communication confidence (t=3.12, p=.001) than those of the control group. Conclusions: SBAR communication simulation training for nursing student not only promotes communication skill among healthcare professionals, but also helps reduce communication errors for patient safety. For effective communication with healthcare professionals in neonatal intensive care unit, SBAR simulation training should be included in nursing education for communication.